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All topics
  1. What it is
  2. Why it matters
  3. Timing
  4. The procedure
  5. Patient journey
  6. Recovery supplies
  7. Implant materials
  8. Side-by-side
  9. US manufacturers
  10. What the evidence says
  11. Value analysis
  12. Questions to ask
  13. Glossary
  14. Resources
  15. References

Overview

What is cranioplasty?

Cranioplasty is surgery to repair an opening or defect in the skull. Most often it follows a decompressive craniectomy, an emergency operation in which surgeons remove part of the skull so a swollen brain has room to expand. That first operation can be lifesaving after a severe head injury, a large stroke, bleeding in the brain, or infection. Once the swelling settles, the missing section needs to be replaced.

Defects can also come from tumor removal, infected bone that had to be taken out, a bone flap that broke down over time, or problems present from birth.

The missing piece can be rebuilt with the patient's own bone (called autologous) or with a manufactured material (called alloplastic). This guide focuses on the alloplastic options, with the patient's own bone included as the reference point most comparisons use.

Clinical detail

Typical indications include post-decompressive defects after TBI, malignant MCA infarction, ICH and aneurysmal SAH, as well as post-oncologic resection, osteomyelitis with flap removal, and aseptic bone flap resorption after prior autologous cranioplasty. In a systematic review of syndrome of the trephined, TBI was the most common indication for the preceding craniectomy (43%), followed by tumor resection (23%).2

Sources for this page

  1. Mustroph CM, et al. Systematic review of syndrome of the trephined and reconstructive implications. J Craniofac Surg. 2022;33(6):e647-e652. doi:10.1097/SCS.0000000000008724

All references